We’ve made great strides in a lot of diseases. Over the years death rates from heart disease continue to go down. Survival from cancers is going up. But one disease still keeps climbing and that’s diabetes. The prevalence of diabetes is between 7% and 9% in adults. And it increases with age such that 1 in 5 people over 60 years have it. Therefore, preventing diabetes is important for all of us.
Diabetes is a condition in which the body can no longer manage the amount of sugar (in the form of glucose) in the blood within an ideal range. In a healthy state, your body uses the hormone insulin to clear sugar from the blood to be used for energy or stored in the muscles and organs for later use.
Diabetes of Different Types
There are two types of diabetes, type 1, which results from the body’s inability to produce insulin. This is most commonly recognized in children and has a genetic component to it. Type 1 diabetes accounts for about 10% of all diabetes.
The other type, type 2, is the inability of insulin to clear out sugar from the blood. This is because the muscles and organs no longer respond to insulin as well as before. In a sense, the body becomes resistant to the effects of insulin. As a result, blood sugar rises.
The main concern with the excess blood sugar is that it attacks the lining of the body’s arteries, making them weak. Over time this can lead to a build up of plaque and atherosclerosis. The consequences of diabetes can range from heart disease to early death, and if left untreated blindness, kidney failure and foot amputations are also possible.
While there can be a genetic component to type 2 diabetes (referred to as diabetes hereafter), it’s mainly a disease of lifestyle and is entirely preventable in most people. It was formerly called adult onset diabetes because it used to only be present in adults. However, teenagers and children are now being diagnosed with type 2 diabetes. One of the main reasons diabetes has continued to increase is due to increased obesity. Also contributing are decreases in physical activity and poor nutrition.
Preventing Diabetes With a Healthy Lifestyle
Being physically active is good for your blood sugar levels as sugar is a key energy source. The activity draws in sugar from the blood and your levels go down. In many diabetic education centres, patients are commonly led on a walk to demonstrate how their levels decrease from before to after the walk.
Conversely, prolonged sitting, can increase your risk for diabetes. When you sit for a long time, your body’s engine shuts off. Since your not moving the blood sugar stays in your blood. One study reported that for every two hours per day of televisions viewing, the chances of getting diabetes rose by 20%.
But it doesn’t take much to turn that around. Getting up every 20 minutes and walking for two minutes is enough to reduce blood sugar levels. When it comes to controlling blood sugar, mixing sitting with short bouts of light activity is better than sitting for long periods and going for exercise later in the day.
It should also be no surprise that diet plays a role. While there’s no magic diet for preventing diabetes, reducing processed foods and those high in refined sugar is a good first step. Replace pop with water as having one to two cans of soda per day increases your risk of diabetes by 26%. Drinking smoothies and fruit juice isn’t much better, since they have as much sugar as pop. In addition, limit or avoid, white bread, white rice, pasta and noodles. Ensuring you get adequate protein and healthy fats such as nuts and avocados can help round out your diet.
When you eat is also as important as what you eat. Late-night eating can lead to higher blood sugar levels. This is because melatonin, released during nighttime reduces insulin. Your body does this so that sugar levels don’t go too low while sleeping. However, eating right before bed will lead to higher sugar levels than you need.
And don’t forget to get a good night’s sleep. While 7 to 9 hours of sleep is recommended, many people have challenges getting this much. But when you’re tired, you tend to crave energy-dense foods high in sugar. This can lead to an increase chance of obesity and diabetes.
More Bang for Your Buck
The benefit of doing all of these lifestyle behaviours really adds up. People at risk for diabetes who underwent a program of diet, physical activity and 5% weight loss had a 60% less chance for diabetes.
Lifestyle is even better than drugs in preventing diabetes as demonstrated in the popular Diabetes Prevention Program (above graph). This program consisted of modest weight loss, diet and physical activity counselling. Compared to a common blood sugar lowering drug, metformin, the lifestyle program reduced the chances of getting diabetes by 39%.
And if you have type 2 diabetes, weight loss through diet with exercise can lead to remission . In patients who lost as little as 11 pounds, 5% no longer needed to be on medications. For those who lost as much as 33 pounds, over 70% had remission of their diabetes.
From these studies, it’s clear that weight, or rather body fat, plays a key role in diabetes. This is because excess body fat interferes with how insulin works and leads to insulin resistance. Fat around the waist is particularly problematic. Even if you’re of ideal body weight, a larger waist can increase your chances of getting diabetes.
And while you’re living a healthy lifestyle and lowering your chances of getting diabetes, you’re also reducing your chances of getting heart disease, cancer and other chronic diseases.
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